Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 5101017675 | MI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 5101017675 | MI |
NPI | 1205094901 |
---|---|
Provider Name | David Andrew Knesek |
First Address | Novi, MI 48374-1256 |
Second Address | Southfield, MI 48075-6212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 23/04/2019 |